Cytomegalovirus infection and epicardial adipose tissue in liver transplant recipients-Results from a nationwide prospective cohort study.

OBJECTIVES

Liver transplant recipients face increased cardiovascular disease risk, but the pathogenesis is not clear. Cytomegalovirus (CMV) infection, which is common after liver transplantation, has been associated with cardiovascular events. Epicardial adipose tissue (EAT) could represent an unrecognized mediator of CMV-related cardiovascular risk. We aimed to investigate if prior CMV infection was associated with EAT volume in liver transplant recipients.

METHODS

From the national prospective Danish Comorbidity in Liver Transplant Recipients Study, we invited liver transplant recipients for protocolized research cardiac computed tomography and assessed EAT volume. Participants were systematically screened for CMV DNAemia and disease with repetitive posttransplantation polymerase chain reaction tests. Using linear regressions, we investigated the relationship between prior CMV infection and EAT volume indexed to body surface area (iEAT).

RESULTS

We included 165 liver transplant recipients, of whom 54 had prior CMV DNAemia, and 20 had prior CMV disease. Both were associated with lower iEAT, -7.52 (95% confidence interval [CI]: -14.1, -0.99) ml/m2 and -10.5 (95% CI: -19.8, -1.09) ml/m2 respectively, adjusted for age, sex, smoking, time since transplantation, steroid-use, dyslipidemia, and diabetes.

CONCLUSION

Prior CMV infection was associated with lower EAT volume, suggesting that CMV affects ectopic fat and that CMV does not increase cardiovascular risk via EAT.